CT三期增强扫描对胃癌淋巴结转移的诊断价值  

Diagnostic Value of Tri-phasic Enhanced Spiral CT in the Diagnosis of Lymph Node Metastasis of Gastric Carcinoma

作　　者：乔英[1] 李健丁[1] 张瑞平[1] 鄂林宁[1] 张华[1] 

机构地区：[1]山西医科大学附属第一医院放射科,太原030001

出　　处：《放射学实践》2006年第5期507-510,共4页Radiologic Practice

摘　　要：目的:评价螺旋CT三期增强扫描对胃癌淋巴结转移的诊断价值,探讨转移淋巴结的CT三期增强扫描特征。方法:对73例进展期胃癌患者行CT平扫及三期动态增强扫描,并与手术病理结果对照。结果:转移淋巴结的主要CT征象:较小转移淋巴结以实性为主,随直径增大呈环状、囊状改变者增加;强化类型分为实性均匀强化,环带样强化和囊状不强化;强化峰值时间不同,以动脉期达强化峰值者多见。CT三期增强扫描诊断胃癌淋巴结转移的诊断符合率为86.3%,敏感度为86.2%,特异度为86.7%。CT三期增强扫描对转移淋巴结的检出率及诊断准确性高于CT平扫,二者间差异有显著性意义(P<0.05)。结论:CT三期增强扫描可进一步提高对胃癌淋巴结转移的诊断准确性,对术前全面评价淋巴结转移状况有重要临床价值。Objective：To investigate the diagnostic value of tri-phasic enhanced spiral CT in the diagnosis of lymph node metastasis in gastric carcinoma as well as its CT manifestations. Methods： Both plain and tri-phasic enhanced spiral CT scan of upper abdomen were performed in 73 patients with advanced gastric carcinoma , and the results were correlated with the surgical and pathologic findings. Results：The main features of lymph node metastases of gastric carcinoma with plain and tri-phasic enhanced spiral CT scan were：solid and homogeneous pattern,mainly in small lymph node;annular or cystic pattern in bigger nodes. The degree of lymph node enhancement was higher in arterial phase compared with that in venous and delay phases , For the tri-phasic enhanced spiral CT scan, the accuracy was 86.3 %, sensitivity 86.2 % , specificity 86.7 % , respectively. The diagnosis accuracy and detectability of metastatic lymph node by tri-phasic enhanced spiral CT is better than that of plain scan,there was significant statistical difference between the two groups （P〈0.05）. Conclusion：The diagnostic accuracy of lymph node metastases in advanced gastric carcinoma can be improved by tri-phasic enhanced spiral CT.

关 键 词：胃肿瘤 淋巴结 转移 体层摄影术 X线计算机 

分 类 号：R735.2[医药卫生—肿瘤]